Over 300 million children grow up in environments of extreme poverty, and the biological and psychosocial hazards endemic to these environments often expose these children to infection, disease, and consequent inflammatory responses. Chronic inflammation in early childhood has been associated with diminished cognitive outcomes and despite this established relationship, the mechanisms explaining how inflammation affects brain development are not well known. Importantly, chronic inflammation is very common in areas of extreme poverty, raising the possibility that it may serve as a mechanism explaining the known relationship between low socioeconomic status (SES) and atypical brain development. To examine these potential pathways, seventy-nine children growing up in an extremely poor, urban area of Bangladesh underwent structural MRI scanning at six years of age. Structural brain images were submitted to Mindboggle software, a Docker-compliant and high-reproducibility tool for tissue segmentation and regional estimations of volume, surface area, cortical thickness, sulcal depth, and mean curvature. Concentration of C-reactive protein was assayed at eight time points between infancy and five years of age and the frequency with which children had elevated concentrations of inflammatory marker served as the measure of chronic inflammation. SES was measured with years of maternal education and income-to-needs. Chronic inflammation predicted total brain volume, total white matter volume, average sulcal depth, and bilateral putamen volumes. Chronic inflammation also mediated the link between maternal education and bilateral putamen volumes. These findings suggest that chronic inflammation is associated with brain morphometry globally and in the putamen, and further suggests that inflammation may be a potential mechanism linking SES to brain development.
Brain Morphometry and Diminished Physical Growth in Bangladeshi Children Growing up in Extreme Poverty: a Longitudinal Study
